Senior resident phacoemulsification learning cure

Carricondo, Pedro Carlos; Fortes, Ana C.; Mourão, Paula; Hajnal, M.; José, Newton Kara

doi:10.1590/s0004-27492010000100012

Cited by 27 publications

(24 citation statements)

References 17 publications

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“…The incidence of vitreous loss during ECCE by residents was reported to be about 2.4-9%, while in phacoemulsification, it ranged from 1.8% to 10%. [1234] We would like to train residents who had no ECCE experience to perform phacoemulsification safely and quickly. Herein, we established a step-by-step training program (SBSTP) and followed each resident included in this program to observe their learning curve and thereby evaluate training effectiveness.…”

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confidence: 99%

Step-by-step phacoemulsification training program for ophthalmology residents

Wang¹,

Yaohua²,

Jin-hua³

et al. 2013

Indian J Ophthalmol

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Aims:The aim was to analyze the learning curve of phacoemulsification (phaco) performed by residents without experience in performing extra-capsular cataract extraction (ECCE) in a step-by-step training program (SBSTP).Materials and Methods:Consecutive surgical records of phaco performed from March 2009 to Sept 2011 by four residents without previous ECCE experience were retrospectively reviewed. The completion rate of the first 30 procedures by each resident was calculated. The main intraoperative phaco parameter records for the first 30 surgeries by each resident were compared with those for their last 30 surgeries. Intraoperative complications in the residents’ procedures were also recorded and analyzed.Results:A total of 1013 surgeries were performed by residents. The completion rate for the first 30 phaco procedures was 79.2 ± 5.8%. The main reasons for halting the procedure were as follows: Anterior capsule tear, inability to crack the nucleus, and posterior capsular rupture during phaco or cortex removal. Cumulative dissipated energy of phaco power used during the surgeries was significantly less in the last 30 cases compared with the first 30 cases (30.10 ± 17.58 vs. 55.41 ± 37.59, P = 0.021). Posterior capsular rupture rate was 2.5 ± 1.2% in total (10.8 ± 4.2% in the first 30 cases and 1.7 ± 1.9% in the last 30 cases, P = 0.008; a statistically significant difference).Conclusion:The step-by-step training program might be a necessary process for a resident to transit from dependence to a self-supported operator. It is also an essential middle step between wet lab training to performing the entire phaco procedure on the patient both effectively and safely.

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confidence: 99%

Step-by-step phacoemulsification training program for ophthalmology residents

Wang¹,

Yaohua²,

Jin-hua³

et al. 2013

Indian J Ophthalmol

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“…7 It is well recognised that a significant learning curve exists for surgeons training to perform cataract surgery. This is the same for experienced surgeons learning the technique for the first time, [8][9][10] or trainees with no previous experience of intraocular surgery. 2 PCR with or without vitreous loss is the most common significant intra-operative complication during modern cataract surgery and is widely considered as the benchmark complication to judge surgical quality.…”

Section: Discussionmentioning

confidence: 99%

Intensive cataract training: a novel approach

Baxter

Lee

Sharp

et al. 2013

Eye

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Purpose To evaluate the safety of an intensive cataract surgery training programme. Methods An intensive cataract surgery training programme was implemented in August 2010 for year 3 ophthalmology trainees in the East Midlands Deanery North Rotation (United Kingdom). Trainees participated in extra-ocular surgery and 50 h of virtual reality cataract surgery simulator training over a 2-year period. Their third year comprised 6 months of intensive phacoemulsification training in a tertiary centre followed by a 6-month period of consolidation in a district general hospital. The complication rates and case numbers were evaluated after the first 2 years of implementation. Results At 2 years, three trainees had completed a full year of intensive training. In the first 6 months of training, Trainee 1 completed 156 cases, Trainee 2 completed 194 cases, and Trainee 3 completed 151 full cases as primary surgeons with an average rate of posterior capsule rupture (PCR) of 1%. At 12 months, Trainee 1 completed 291, Trainee 2 completed 318, and Trainee 3 completed 294 cases, with an average PCR rate of 0.66%. The trainees required 84 lists on average to complete 150 full cataract procedures. Conclusion The combination of simulation and the new intensive training programme is safer than the traditional programme for cataract surgery training.

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“…[12] Carricondo et al, studying resident-performed phacoemulsification surgery indicated a statistically significant difference in PCR rates between the first 40 cases per resident and the total number of operations yielding a mean of 9.65% in the first 40 operations, data comparable to our results. [13] Several other studies showed lower complication rates in residents training programs varying from 3% to 7%. [9][10][11][12][13][14][15][16] …”

Section: P Valuementioning

confidence: 94%

“…[13] Several other studies showed lower complication rates in residents training programs varying from 3% to 7%. [9][10][11][12][13][14][15][16] …”

Section: P Valuementioning

confidence: 94%

Surgical Challenges Faced by Trainee Surgeons- A Prospective Comparative Study

Mushriff¹,

Telgote²,

Patel³

2017

jemds

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BACKGROUNDHuman resources like Doctors form the important part of all health systems. To achieve health objectives and goals, health resources should be distributed evenly among people irrespective of economic, social and geographical barriers. The aim of this study is to evaluate the surgical challenges faced by trainee Ophthalmologists and to compare the efficacy of two different methods of training; step-by-step method and one-step method are the two ways of training practiced to train ophthalmologists. This study compares the two ways of training by evaluating complications at the end of surgeries performed by trainee surgeons. Setting-Department of Ophthalmology, Index Medical College and Research Centre. Study Design-A Prospective Comparative Study. MATERIALS AND METHODSTime Period-1 st January 2017 to 31 st March 2017, 3 months. Cataract Surgery performed-Manual Small Incision Cataract Surgery performed within the above-mentioned period (80 SICS). Study was divided into 2 Groups accordinglyGroup 1-Including residents that were trained with the 'step-by-step' method (44 SICS). Group 2-Including residents that were trained with the 'one-step' method (36 SICS).1. Residents were evaluated for the ease of performing surgical steps. 2. Complications were recorded in terms of premature entry, buttonholing, running away of capsulorhexis, rhexis tear, zonular dialysis/dehiscence, posterior capsular rent/rupture, iridodialysis, vitreous loss. Both of the above-mentioned groups were compared according to various difficulties encountered in each approach and their management was done by the supervising surgeon. Patient was followed for 1 month. Data were listed and counted with Excel (Version 2007, Microsoft). Mean and Standard deviation was calculated. Chi-square and Student t-tests were used to assess statistical significance between groups. RESULTS 44 surgeries were done in "step-by-step" group of which 18 patients were male and 26 were female; and 36 surgeries were done in "one-step" group of which 20 were male and 16 were female. Mean age group of patient in "step-by-step" group was 64.22 ± 10.10 years and 63.50 ± 8.46 years in "one-step" group. Overall complication rate when compared between 2 groups were more in "onestep" group, which was significant in contrast to when individual complication rates were compared between two groups. CONCLUSIONThus to conclude, learning surgery is always an uphill task for a trainee. A great degree of temperament, practice and skills are required before proficiency is achieved. In our study, 2 approaches were practiced in learning SICS-"step-by-step" and "one-step"; and "step-by-step" approach was found beneficial for the beginners. KEYWORDS SICS, Trainee Surgeon, Cataract, Post-Operative Complication. HOW TO CITE THIS ARTICLE:Mushriff S, Telgote V, Patel K. Surgical challenges faced by trainee surgeons-a prospective comparative study.

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Senior resident phacoemulsification learning cure

Cited by 27 publications

References 17 publications

Step-by-step phacoemulsification training program for ophthalmology residents

Step-by-step phacoemulsification training program for ophthalmology residents

Intensive cataract training: a novel approach

Surgical Challenges Faced by Trainee Surgeons- A Prospective Comparative Study

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